Individual provider Active NPI

Flavia A Caceres

  • Community Health Worker
  • Vancouver, WA
National Provider Identifier
1366062192
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
PC60733562 Issued in WA
Practice address
1601 E Fourth Plain Blvd BLDG 17
Vancouver, WA 98661-3717
Phone
(564) 397-8000
Fax
(564) 397-8110
NPI assigned
Apr 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X PC60733562 WA Primary

Addresses

Primary practice location

1601 E Fourth Plain Blvd BLDG 17
Vancouver, WA 98661-3717

Mailing address

PO Box 9825
Vancouver, WA 98666-8825
Phone (564) 397-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PC60733562WAMDCommunity Health Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1366062192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9825",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986668825",
            "telephone_number": "564-397-8000",
            "fax_number": "564-397-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E FOURTH PLAIN BLVD BLDG 17",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613717",
            "telephone_number": "564-397-8000",
            "fax_number": "564-397-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACERES",
        "first_name": "FLAVIA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "WA",
            "license": "PC60733562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.